In diagnosing what's wrong with the U.S. health care system, President Obama has suggested, among other things, that some doctors make decisions about care based on how much money they make off certain treatments.
In July, Obama described a scenario in which a doctor treating a child with a severe sore throat may be influenced more by money than principle.
"The doctor may look at the reimbursement system and say to himself, 'You know what, I make a lot more money if I take this kid's tonsils out,'" he said.
Obama's notion that health care is too expensive partly because physicians intentionally choose treatment with higher reimbursements deeply offended doctors.
"The characterization that physicians would do this just for profit motive or gain I think that was a bit in error," said Dr. Ted Epperly of the American Academy of Family Physicians.
"For the president to say the physicians are ... doing this for compensation -- it's such a disservice to the health care reform debate, it ultimately accomplishes nothing other than to fan the flames," said Dr. Daniel Palestrant, founder and chief executive of Sermo, Inc., a physicians-only online network.
At another point, Obama explained that if diabetes are not treated properly in their primary care, they can face the amputation of a limb.
"That's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed," Obama said.
Most people agree preventive care is important and saves money. But doctors also say the president's numbers and understanding are way off -- that doctors would be paid $500 to $2,000 for an amputation, not $50,000.
And in any case, they argue, that's not relevant to choices about care.
"We know that the ethics and practice of medicine and surgery is such that a physician or surgeon would not decide what treatment is best based on the reimbursement involved," Dr. Joseph Zuckerman of Orthopedic Surgeons said.